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While there is little debate about a growing primary care workforce shortage in the United States, precise estimates of current and projected need vary. A secondary problem contributing to addressing capacity shortfalls is that the distribution of primary care practitioners often is mismatched with patient needs. For example, patients in rural areas or low-income patientsparticularly the uninsuredmay have greater problems accessing primary care services than well-insured, suburban residents. Most efforts to improve access to primary care services center on increasing the supply of practitioners through training, educational loan forgiveness or scholarships, credentialing, and higher payment rates. The 2010 Patient Protection and Affordable Care Act (PPACA) includes many provisions promoting these strategies. While existing, longer-term efforts to boost the primary care workforce are necessary, they may be insufficient for some time because a meaningful increase in practitioners will take decades. Rather, policy makers may want to consider ways to increase the productivity of primary care providers and accelerate primary care workforce expansion by, for example, examining how changes in state scope-of-practice policies might increase the supply of non-physician practitioners.

This article is available at the National Institute for Health Care Reform Web site by clicking here.